The impact of the COVID-19 pandemic on the provision of dental procedures performed by the Brazilian Unified Health System: a syndemic perspective

Abstract

Objectives: This study investigated the impact of the COVID-19 pandemic on the provision of dental care procedures performed by the Brazilian Unified Health System (SUS) nationally and by regions. Considering that the most underprivileged population disproportionately suffers with the reduction in dental care provision, the study hypothesis suggests the presence of a syndemic nature. Methodology: The SUS Outpatient Information System (SIA-SUS) was assessed to gather data on dental care activities and procedures performed between April and July 2018, 2019, and 2020 by dentists registered in the SUS. The 30 most frequent activities and procedures performed by dentists were selected and classified into three categories (urgent dental care, nonemergency dental care, and case-dependent urgency procedures), based on the guidance for dental care during the pandemic published by the American Dental Association. Results: Results demonstrated a reduction in the provision of dental care of all categories during the pandemic. Urgency dental consultations and procedures in primary and specialized dental care services decreased by 42.5 and 44.1%, respectively, between 2020 and 2019. Non-urgent procedures decreased by 92.3%. Although decreases in dental care activities and procedures were reported in all Brazilian regions, the largest relative decreases in urgent procedures – that should have been maintained during the pandemic – occurred in the North and Northeast regions, which are the poorest regions of the country. Conclusions: These results suggest that the COVID-19 pandemic has a syndemic behavior. Further investigation into the pandemic-syndemic impacts on oral disease burden is necessary.

Impact of the COVID‐19 pandemic on public University laboratories of oral and maxillofacial pathology: A Brazilian multicenter study

“…Considering that the nine laboratories included in the study are reference services in oral pathology within their regions and that this study covered the longest follow‐up period after the onset of the pandemic to date, the results presented herein, despite the limitations of the study, provide an overview of the effect of the COVID‐19 pandemic on the diagnosis of oral and maxillofacial lesions in Brazil. Some studies have shown the impact of the COVID‐19 pandemic on the routine of diagnostic services (Alves et al, 2020; Cunha et al, 2021; Dinmohamed et al, 2020; Tsai et al, 2020). In a comparison of the first three months of the pandemic to the same period of the year 2019, da Cunha and et al (2020) observed a sharp reduction of 68.8% in the rate of biopsies of the soft tissues of the mouth performed by the Brazilian public Unified Health System (Sistema Único de Saúde ‐ SUS).…”

Repercussões da epidemia de COVID-19 nos atendimentos odontológicos de urgência do Sistema Único de Saúde em Piracicaba, 2020

“…Este fato, particularmente, corrobora os achados de Cunha et al . 23 sobre os serviços públicos odontológicos de todo o país, onde se verificou, mediante comparação dos dados do Sistema de Informações Ambulatoriais do Sistema Único de Saúde, entre os meses de abril e junho de 2019 e durante o ano de 2020, uma diminuição de 88,4% na produtividade total dos serviços ofertados pela Atenção Básica e Especializada, e redução de 87% nas extrações realizadas, tal como verificado por estudos desenvolvidos em outros países. 18 Algumas hipóteses são levantadas para justificar os resultados do presente estudo.…”

The impact of COVID-19 on individual oral health: a scoping review

“…A study undertaken in Saudi Arabia reported that patients were afraid to seek dental care for life-threatening emergencies such as cellulitis during the pandemic [62]. There were some declines in the use of emergency services during the pandemic [62][63][64][65][66][67][68][69][70] with one study reporting that patients with significant comorbidities sought emergency dental services less frequently during the lockdown period [68].…”